Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety

López-Callejas Orlando,Ortiz-Giraldo Andres F,Vera Daniela D,Ramirez-Rojas Diego A,Villamizar-Barahona Ana B,Ferreira-Prada Carlos A.,Galvis Melquizidel,Vargas-Pérez Oliverio,Serrano-Gómez Sergio,Reye 대한신경중재치료의학회 2023 Neurointervention Vol.18 No.1

Purpose: Internal carotid artery (ICA) aneurysm treatment with a flow diverter (FD) has shown an adequate efficacy and safety profile, presenting high complete occlusion or near occlusion rates with low complications during follow-up. The purpose of this study was to evaluate the efficacy and safety of FD treatment in non-ruptured internal carotid aneurysms.Materials and Methods: This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured ICA aneurysms treated with an FD between January 1, 2014, and January 1, 2020. We analyzed an anonymized database. The primary effectiveness endpoint was complete occlusion (O’Kelly–Marotta D, OKM-D) of the target aneurysm through 1-year follow-up. The safety endpoint was the evaluation of modified Rankin Scale (mRS) 90 days after treatment, considering a favorable outcome an mRS 0-2.Results: A total of 106 patients were treated with an FD, 91.5% were women; the mean follow- up was 427.2±144.8 days. Technical success was achieved in 105 cases (99.1%). All patients included had 1-year follow-up digital subtraction angiography control; 78 patients (73.6%) completed the primary efficacy endpoint by achieving total occlusion (OKM-D). Giant aneurysms had a higher risk of not achieving complete occlusion (risk ratio, 3.07; 95% confidence interval, 1.70 - 5.54]). The safety endpoint of mRS 0-2 at 90 days was accomplished in 103 patients (97.2%).Conclusion: Treatment of unruptured ICA aneurysms with an FD showed high 1-year total occlusion results, with very low morbidity and mortality complications.

Phenotypic Characteristics and Clonal Relationships of Stenotrophomonas maltophilia Isolates in Hospitalized Adults from a Private Center in Lima, Peru

Ortiz-Gómez Tamin,Toledano Paula,Gomez Andrea C.,López María,Alonso Carla Andrea,Ruiz Joaquim,Lagos José,Sáenz Yolanda 대한감염학회 2023 Infection and Chemotherapy Vol.55 No.2

Stenotrophomonas maltophilia is an opportunistic pathogen, often associated with nosocomial infections. Ten S. maltophilia were isolated from clinical samples during the period January 2021 and June 2022. Eight (80%) patients had cancer as a background disease and 2 patients had coronavirus disease 2019. A fatal outcome was recorded in 4 cases (40% of patients). All the isolates were susceptible to minocycline and levofloxacin. Trimethoprim/sulfamethoxazole and ceftazidime resistance rates were 20% and 40% respectively. Eight different patterns were observed by Pulsed-Field Gel Electrophoresis, only two isolates being clonally identical. The isolation of S. maltophilia in clinical settings requires the implementation of infection prevention measures.

Ribociclib-Related Stevens–Johnson Syndrome: Oncologic Awareness, Case Report, and Literature Review

Victoria López-Gómez,Ramón Yarza,Héctor Muñoz-González,Enrique Revilla,Santos Enrech,Olga González-Valle,Pablo Tolosa,Eva Ciruelos 한국유방암학회 2019 Journal of breast cancer Vol.22 No.4

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis belong to a severe dermatopathic spectrum that includes frequently fatal mucocutaneous manifestations consisting of whole epidermal necrosis and sloughing with bullous transformation, blistering, and further skin detachment. Notably, cancer patients are at higher risk of developing SJS than the general population as a consequence of both the nature of neoplastic disease and frequent exposure to anticancer drugs. Ribociclib is a newly approved cycline-dependent kinase inhibitor that has been recently associated with a single case of SJS. We hereby present a case of ribociclib-related SJS. Early detection of threatening skin lesions is crucial to permit the immediate discontinuation of ribociclib given the predictable and unacceptable risk level. In cases of established SJS, early aggressive support should be initiated, ribociclib should be abruptly discontinued, and specific treatment based on actual evidence should be started.

Mechanical Characterization of the Welding of Two Experimental HSLA Steels by Microhardness and Nanoindentation Tests

Edgar López-Martínez,Octavio Vázquez-Gómez,Héctor Javier Vergara-Hernández,Sergio Serna,Bernardo Campillo 대한금속·재료학회 2016 METALS AND MATERIALS International Vol.22 No.6

The microhardness and nanohardness of the welding zone of two experimental HSLA steels were determined. The first steel has a microstructure of martensite and bainite, and the second one has a microstructure of quasipolygonalferrite and acicular ferrite. In the bainitic - martensitic steel, softening of the heat affected zone wasobserved. This softening can be attributed to: the formation of polygonal ferrite in the recrystallization subzone,the formation of quasi-polygonal ferrite and the tempering of martensite in the intercritical subzone, andthe tempering of martensite in the subcritical subzone. Besides the softening, with nanoindentation technique, hardeningwas observed at the position where the peak temperature reached the critical temperature Ac1, which canbe attributed to a phenomenon of secondary hardening by precipitation of carbides of alloying elements. In theferritic steel, a softening phenomenon did not appear since there was no martensite in its initial microstructure. Finally, it was noted that both polygonal ferrite and the bainite have similar behavior and nanohardness, thiscoincidence can be attributed to the effect of grain boundary.

Role of Multiparametric Prostate Magnetic Resonance Imaging before Confirmatory Biopsy in Assessing the Risk of Prostate Cancer Progression during Active Surveillance

Salguero Joseba,Gómez-Gómez Enrique,Valero-Rosa José,Carrasco-Valiente Julia,Mesa Juan,Martin Cristina,Campos-Hernández Juan Pablo,Rubio Juan Manuel,López Daniel,Requena María José 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.4

Objective: To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) before confirmatory prostate biopsy in patients under active surveillance (AS). Materials and Methods: This retrospective study included 170 patients with Gleason grade 6 prostate cancer initially enrolled in an AS program between 2011 and 2019. Prostate mpMRI was performed using a 1.5 tesla (T) magnetic resonance imaging system with a 16-channel phased-array body coil. The protocol included T1-weighted, T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging sequences. Uroradiology reports generated by a specialist were based on prostate imagingreporting and data system (PI-RADS) version 2. Univariate and multivariate analyses were performed based on regression models. Results: The reclassification rate at confirmatory biopsy was higher in patients with suspicious lesions on mpMRI (PI-RADS score ≥ 3) (n = 47) than in patients with non-suspicious mpMRIs (n = 61) and who did not undergo mpMRIs (n = 62) (66%, 26.2%, and 24.2%, respectively; p < 0.001). On multivariate analysis, presence of a suspicious mpMRI finding (PI-RADS score ≥ 3) was associated (adjusted odds ratio: 4.72) with the risk of reclassification at confirmatory biopsy after adjusting for the main variables (age, prostate-specific antigen density, number of positive cores, number of previous biopsies, and clinical stage). Presence of a suspicious mpMRI finding (adjusted hazard ratio: 2.62) was also associated with the risk of progression to active treatment during the follow-up. Conclusion: Inclusion of mpMRI before the confirmatory biopsy is useful to stratify the risk of reclassification during the biopsy as well as to evaluate the risk of progression to active treatment during follow-up.

Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm

Juan Luis Gómez-Amador,Leoncio Alberto Tovar-Romero,Andrea Castillo-Matus,Ricardo Marian-Magaña,Jorge Fernando Aragón-Arreola,Marcos Vinicius Sangrador-Deitos,Alan Hernández-Hernández,Germán López-Val 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4

Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm’s wall obstructing the left DACA flow. We proceeded to open the aneurysm’s dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA.Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient’s postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.

Genomic surveillance links livestock production with the emergence and spread of multi-drug resistant non-typhoidal Salmonella in Mexico

Enrique Jesús Delgado-Suárez,Rocío Ortíz-López,Wondwossen A. Gebreyes,Marc W. Allard,Francisco Barona-Gómez,María Salud Rubio-Lozano 한국미생물학회 2019 The journal of microbiology Vol.57 No.4

Multi-drug resistant (MDR) non-typhoidal Salmonella (NTS) is increasingly common worldwide. While food animals are thought to contribute to the growing antimicrobial resistance (AMR) problem, limited data is documenting this relationship, especially in low and middle-income countries (LMIC). Herein, we aimed to assess the role of non-clinical NTS of bovine origin as reservoirs of AMR genes of human clinical significance. We evaluated the phenotypic and genotypic AMR profiles in a set of 44 bovine-associated NTS. For comparative purposes, we also included genotypic AMR data of additional isolates from Mexico (n = 1,067) that are publicly available. The most frequent AMR phenotypes in our isolates involved tetracycline (40/44), trimethoprim-sulfamethoxazole (26/44), chloramphenicol (19/44), ampicillin (18/44), streptomycin (16/44), and carbenicillin (13/44), while nearly 70% of the strains were MDR. These phenotypes were correlated with a widespread distribution of AMR genes (i.e. tetA, aadA, dfrA12, dfrA17, sul1, sul2, bla-TEM-1, blaCARB-2) against multiple antibiotic classes, with some of them contributed by plasmids and/or class-1 integrons. We observed different AMR genotypes for betalactams and tetracycline resistance, providing evidence of convergent evolution and adaptive AMR. The probability of MDR genotype occurrence was higher in meat-associated isolates than in those from other sources (odds ratio 11.2, 95% confidence interval 4.5–27.9, P < 0.0001). The study shows that beef cattle are a significant source of MDR NTS in Mexico, highlighting the role of animal production on the emergence and spread of MDR Salmonella in LMIC.

Changes in Heart Rate Variability in Patients with Spleen-Qi Deficiency Syndrome

Agnese Olivera-Toro,Rubén Fossion,Lei Li,Rosa E. López-Gómez,Emma López-Espinosa,Ismael Jiménez-Estrada,Salvador Quiroz-González 사단법인약침학회 2019 Journal of Acupuncture & Meridian Studies Vol.12 No.4

Many functional diseases are related to dysautonomia, and heart rate variability has been used to assess dysautonomia. However, heart rate variability has not been studied in Spleen-Qi deficiency syndrome (SQDS). Healthy volunteers (n Z 37) and patients with SQDS (n Z 67), recruited from the Clinic of the State University of Ecatepec Valley were included in the study. Outcome measures were average heart rate, standard deviation of the normal-to-normal heartbeat intervals, low frequency (LF), high frequency (HF) power, and the LF/HF ratio. Also, intestinal peristalsis, gastrointestinal symptoms (GSs), fatigue, and level of attention were measured. Standard deviation of the normal-to-normal heartbeat intervals (17 Æ 2.3%) and HF (14 Æ 3.1%) were lower in SQDS patients (17 Æ 1.3%) than in healthy volunteers. SQDS patients had higher heart rate, LF power, LF/HF ratio, and fatigue scores (9.6 Æ 1.12%, 16 Æ 2.1%, 22 Æ 3.8%, and 21 Æ 4.1%). The fatigue correlated positively with the LF/HF ratio and negatively with HF power. The SQDS group had lower concentration performance (16.2 Æ 1.9%) in the d2 test. The intestinal peristalsis showed a reduction (15 Æ 1.3%) as compared with control. GS score and peristalsis correlated negatively with HF. Our results suggest that the pathology of SDQS could be associated with a low vagal tone which causes a decrease in peristalsis, increased fatigue, reduced attention, and appearance of GSs.

Comparison of the Antimicrobial Activity of Hibiscus sabdariffa Calyx Extracts, Six Commercial Types of Mouthwashes, and Chlorhexidine on Oral Pathogenic Bacteria, and the Effect of Hibiscus sabdariffa Extracts and Chlorhexidine on Permeability of the Ba

Elena Saraí Baena-Santillán,Javier Piloni-Martini,Eva María Santos-López,Carlos Alberto Gómez-Aldapa,Esmeralda Rangel-Vargas,Javier Castro-Rosas 한국식품영양과학회 2021 Journal of medicinal food Vol.24 No.1

To determine and compare the antimicrobial effect of Hibiscus sabdariffa calyx extracts, six types of commercial mouthwashes, and chlorhexidine on Streptococcus mutans, Streptococcus sanguinis, Capnocytophaga gingivalis, and Staphylococcus aureus. Two varieties of H. sabdariffa cultivated in Mexico were used. Aqueous, methanolic, ethanolic, acetonic, and ethyl acetate extracts were obtained from H. sabdariffa calyces. Six different types of mouthwash (Astringosol®, Colgate plax-ice-infinity®, Crest pro-health®, Dental max®, Equate®, and Listerine zero®) and chlorhexidine (0.12%) were purchased at a pharmacy. The antimicrobial activity of the H. sabdariffa calyx extracts, mouthwashes, and chlorhexidine was determined by the agar disc diffusion technique. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of all solutions were determined by the broth dilution method and the pour plate technique, respectively. Also, the effect of H. sabdariffa extracts and chlorhexidine on permeability of the bacterial membrane was determined by the violet crystal assay. All H. sabdariffa calyx extracts and chlorhexidine showed antibacterial activity against all oral pathogenic bacteria. The mouthwashes showed lower antibacterial effect than H. sabdariffa extracts and chlorhexidine. Dental max showed no antibacterial effect. The MICs and MBCs, respectively, for H. sabdariffa extracts were between 5–20 and 10–20 mg/mL; and for chlorhexidine, between 3–4 and 3–5 mg/mL. For the Listerine®, the MIC and MBC values were between 20–25 and 25–33 mg/mL, respectively. The results of the crystal violet test indicate that H. sabdariffa calyx extracts and chlorhexidine alter the permeability of the bacterial membrane. All H. sabdariffa extracts and chlorhexidine showed significantly greater antimicrobial effect than mouthwashes. This is the first report in which the antimicrobial effect of the H. sabdariffa calyx extracts, mouthwashes, and chlorhexidine is compared.

Diagnostic Yield and Therapeutic Impact of Rectal Retroflexion: A Prospective, Single-Blind Study Conducted in Three Centers

Félix Téllez-Ávila,Josué Barahona-Garrido,Sandra García-Osogobio,Gustavo López-Arce,Jesús Camacho-Escobedo,Angela Saúl,Salvador Herrera-Gómez,Javier Elizondo-Rivera,Rafael Barreto-Zúñiga 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.1

Background/Aims: No clear data have been established and validated regarding whether rectal retroflexion has an important and therapeutic impact. The aim of the present study was to evaluate the diagnostic yield and therapeutic impact of rectal retroflexion compared with straight view examination. Methods: A prospective single-blind study was conducted. Consecutive patients evaluated between October 2011 and April 2012 were included. Results: A total of 934 patients (542 women [58%]) were included. The mean age was 57.4±14.8 years. Retroflexion was successful in 917 patients (98.2%). Distinct lesions in the anorectal area were detected in 32 patients (3.4%), of which 10 (1%) were identified only on retroflex view and 22 (2.4%) on both straight and retroflex views. Of the 32 identified lesions, 16 (50%) were polyps, nine (28.1%) were angiodysplasias, six (18.8%) were ulcers, and one (3.1%) was a flat lesion. All 10 patients (1%) in whom lesions were detected only by rectal retroflexion showed a therapeutic impact. Conclusions: Rectal retroflexion has minimal diagnostic yield and therapeutic impact. However, its low rate of major complications and the possibility of detecting lesions undetectable by straight viewing justify its use.